Congestive heart failure end-of-life considerations: Difference between revisions
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MeshID = D006333| | MeshID = D006333| | ||
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{{Congestive heart failure}} | |||
{{ | {{CMG}}; {{AOEIC}} {{LG}} | ||
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==Overview== | |||
==Overview | |||
==ACC / AHA Guidelines- Treatment of Patients who have Concomitant Disorders (DO NOT EDIT) <ref name=" | ==ACC/AHA Guidelines- Treatment of Patients who have Concomitant Disorders (DO NOT EDIT) <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] ''Circulation'' 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>== | ||
{{cquote| | {{cquote| | ||
===Class I=== | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]=== | ||
1. Ongoing patient and family education regarding prognosis for functional capacity and survival is recommended for patients with [[HF]] at the end of life. ''(Level of Evidence: C)'' | '''1.''' Ongoing patient and family education regarding prognosis for functional capacity and survival is recommended for patients with [[HF]] at the end of life. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
2. Patient and family education about options for formulating and implementing advance directives and the role of [[palliative care|palliative]] and [[hospice care]] services with reevaluation for changing clinical status is recommended for patients with [[HF]] at the end of life. ''(Level of Evidence: C)'' | '''2.''' Patient and family education about options for formulating and implementing advance directives and the role of [[palliative care|palliative]] and [[hospice care]] services with reevaluation for changing clinical status is recommended for patients with [[HF]] at the end of life. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
3. Discussion is recommended regarding the option of inactivating [[ICD]]s for patients with [[HF]] at the end of life. ''(Level of Evidence: C)'' | '''3.''' Discussion is recommended regarding the option of inactivating [[ICD]]s for patients with [[HF]] at the end of life. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
4. It is important to ensure continuity of medical care between inpatient and outpatient settings for patients with [[HF]] at the end of life. ''(Level of Evidence: C)'' | '''4.''' It is important to ensure continuity of medical care between inpatient and outpatient settings for patients with [[HF]] at the end of life. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
5. Components of [[hospice care]] that are appropriate to the relief of suffering, including [[opiate]]s, are recommended and do not preclude the options for use of [[inotrope]]s and intravenous [[diuretic]]s for symptom [[palliation]] for patients with [[HF]] at the end of life. ''(Level of Evidence: C)'' | '''5.''' Components of [[hospice care]] that are appropriate to the relief of suffering, including [[opiate]]s, are recommended and do not preclude the options for use of [[inotrope]]s and intravenous [[diuretic]]s for symptom [[palliation]] for patients with [[HF]] at the end of life. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
6. All professionals working with [[HF]] patients should examine current end-of-life processes and work toward improvement in approaches to [[palliation]] and end-of-life care. ''(Level of Evidence: C)'' | '''6.''' All professionals working with [[HF]] patients should examine current end-of-life processes and work toward improvement in approaches to [[palliation]] and end-of-life care. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
===Class III=== | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]=== | ||
1. Aggressive procedures performed within the final days of life (including [[intubation]] and implantation of a [[cardioverter-defibrillator]] in patients with NYHA functional class IV symptoms who are not anticipated to experience clinical improvement from available treatments) are not appropriate. ''(Level of Evidence: C)''}} | '''1.''' Aggressive procedures performed within the final days of life (including [[intubation]] and implantation of a [[cardioverter-defibrillator]] in patients with NYHA functional class IV symptoms who are not anticipated to experience clinical improvement from available treatments) are not appropriate. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''}} | ||
== | ==Vote on and Suggest Revisions to the Current Guidelines== | ||
* [[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]] | *[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]] | ||
== | ==Guidelines Resources== | ||
* | *[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref> | ||
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] ''Circulation'' 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | |||
[[Category: | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Revision as of 17:05, 3 November 2011
| Heart failure | |
| ICD-10 | I50.0 |
|---|---|
| ICD-9 | 428.0 |
| DiseasesDB | 16209 |
| MedlinePlus | 000158 |
| MeSH | D006333 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
ACC/AHA Guidelines- Treatment of Patients who have Concomitant Disorders (DO NOT EDIT) [1][2]
| “ |
Class I1. Ongoing patient and family education regarding prognosis for functional capacity and survival is recommended for patients with HF at the end of life. (Level of Evidence: C) 2. Patient and family education about options for formulating and implementing advance directives and the role of palliative and hospice care services with reevaluation for changing clinical status is recommended for patients with HF at the end of life. (Level of Evidence: C) 3. Discussion is recommended regarding the option of inactivating ICDs for patients with HF at the end of life. (Level of Evidence: C) 4. It is important to ensure continuity of medical care between inpatient and outpatient settings for patients with HF at the end of life. (Level of Evidence: C) 5. Components of hospice care that are appropriate to the relief of suffering, including opiates, are recommended and do not preclude the options for use of inotropes and intravenous diuretics for symptom palliation for patients with HF at the end of life. (Level of Evidence: C) 6. All professionals working with HF patients should examine current end-of-life processes and work toward improvement in approaches to palliation and end-of-life care. (Level of Evidence: C) Class III1. Aggressive procedures performed within the final days of life (including intubation and implantation of a cardioverter-defibrillator in patients with NYHA functional class IV symptoms who are not anticipated to experience clinical improvement from available treatments) are not appropriate. (Level of Evidence: C) |
” |
Vote on and Suggest Revisions to the Current Guidelines
Guidelines Resources
- 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation [2]
- The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult [1]
References
- ↑ 1.0 1.1 Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. DOI:10.1161/CIRCULATIONAHA.105.167586 PMID: 16160202
- ↑ 2.0 2.1 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967